Refund Application Form - Local Students
This form must be used to apply for a refund. Please complete this form, and return it to ALACC Health College, Australia either in person or via post to Level 1/169 Plenty Road, Preston, Vic, 3072.
Student Name
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Student ID
Course undertaking
*
Please Select
22251VIC ESL II Certificate II in ESL
22255VIC ESL III Certificate III in ESL
22258VIC ESL IV Certificate IV in ESL
CHC30212 Certificate III in Aged Care
CHC40108 Certificate IV in Aged Care
CHC30312 Certificate III in Home and Community
CHC30408 Certificate III in Disability
CHC40312 Certificate IV in Disability
CHC50162 Diploma of Community Services Work
CHC60312 Advanced Diploma Of Community Sector Management
HLT32512 Certificate III in health Services Assistance
HLT32812 Certificate III in Health Support Services
HLT32612 Certificate III in Pathology
HLT41812 Certificate IV in Pathology
HLT51612 Diploma of Nursing (enrolled/division2)
HLTFA311A Apply First Aid
HLTFS207C Follow Basic Food Safety Practices
BSB40812 Certificate IV In Front Line Management
BSB51107 Diploma Of Management
BSB60407 Advanced Diploma Of Management
CHC30113 Certificate III In Early Childhood Education And Care
CHC50113 Diploma Of Early Childhood Education And Care
Medication Unit
Refund Reason
*
W21 - Withdrawal at least 21 days prior to the commencement date student has entered in the application form (which ever is the latter) a full refund of all course fees paid by the student minus a $100
W14 - Withdrawals between 14 and 20 days prior to the commencement date student has entered in the application form (which ever is the latter) a refund of 50% of all course fees paid by the student minus a $100
W13 - Withdrawal less than 14 days prior to commencement of the course or less than 14 days prior to the commencement date the student has entered in the Application Form, (whichever is the later) no refund will be given.
WA - withdrawals after the course or semester commences, no refund is payable.
CAN - Course cancelled or rescheduled by Australasian Lawrence Aged Care College (Full Refund)
Please state why you wish to apply for a refund
*
(Please do not forget to attach evidence to support your claim)
Declaration I have read ALACC’s policy on refund and the information I have provided is true.
*
true
Student signature (Insert your Full Name)
*
Date
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Day
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Month
Year
Date
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PM
AM/PM Option
Office Use Only
Refund Outcome Comments
Evidence for Refund Request Attached
PLEASE ATTACH THIS REFUND APPLICATION TO THE TO REFUND CALCULATION FORM
Submit
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